Being told that you have hip osteoarthritis does not automatically mean you need a hip replacement.

For many people, treatment begins with non-surgical options aimed at:

• Reducing pain
• Improving walking
• Maintaining hip movement
• Strengthening the muscles around the hip
• Making daily activities easier
• Delaying surgery where reasonably possible

Evidence-based non-surgical treatment commonly includes exercise, physiotherapy, activity modification, weight management where relevant, medication and selected injections. The American Academy of Orthopaedic Surgeons recommends physical therapy for people with mild to moderate symptomatic hip osteoarthritis and notes that corticosteroid injections can provide short-term pain and functional improvement.

The objective should not necessarily be:

“How do I avoid hip replacement forever?”

A more useful question is:

“How can I remain comfortable and functional without surgery for as long as it remains reasonable?”

What Is Hip Osteoarthritis?

The hip is a ball-and-socket joint.

With osteoarthritis, changes gradually develop involving:

• Joint cartilage
• Underlying bone
• Joint space
• Surrounding tissues

Typical symptoms include:

• Groin pain
• Hip stiffness
• Pain when walking
• Difficulty climbing stairs
• Difficulty getting out of a chair
• Reduced hip movement
• Pain putting on shoes or socks
• Reduced walking distance

Some people also feel pain in the:

• Buttock
• Thigh
• Knee

Hip arthritis can therefore sometimes be mistaken for another musculoskeletal problem.

Does Hip Arthritis Always Get Worse?

Not at the same rate for everyone.

Some people remain functional for years with manageable symptoms.

Others experience progressive:

• Pain
• Stiffness
• Loss of mobility

The severity seen on an X-ray also does not perfectly predict how much pain a person experiences.

Treatment should therefore consider:

• Symptoms
• Walking ability
• Function
• Examination
• Imaging

rather than the X-ray alone.

Does Hip Arthritis Mean I Need a Hip Replacement?

No.

Hip replacement is generally considered when:

• Pain significantly interferes with everyday life
• Walking has become substantially limited
• Sleep is affected
• Non-surgical treatment is no longer providing acceptable relief

Mayo Clinic describes hip replacement as an option when hip pain interferes with daily activities and non-surgical treatments have not helped or are no longer effective.

What Can I Try Before Hip Replacement?

The main non-surgical options include:

1. Exercise
2. Physiotherapy
3. Activity modification
4. Weight management where appropriate
5. Pain medication
6. Walking aids in selected patients
7. Corticosteroid injection in selected cases

These treatments can be combined rather than viewed as competing alternatives.

1. Exercise for Hip Arthritis

Exercise is one of the most important components of hip arthritis treatment.

It can help maintain:

• Hip movement
• Leg strength
• Walking ability
• Balance
• General fitness

AAOS guidance supports physical therapy and exercise for improving pain and function in people with mild to moderate hip osteoarthritis.

What Type of Exercise Is Good for Hip Arthritis?

Lower-impact activities are often easier to tolerate.

Examples include:

• Walking within your tolerance
• Stationary cycling
• Swimming
• Pool exercise
• Hip strengthening
• Gluteal strengthening
• Balance exercises

AAOS specifically notes that switching from higher-impact activities to options such as swimming or cycling may reduce stress on a painful hip.

But Walking Makes My Hip Hurt — Should I Still Exercise?

This is a common problem.

Being told simply to “exercise more” is not always useful when every walk hurts.

Instead, the programme can be adjusted.

For example:

Instead of:

• A 45-minute continuous walk

you might initially tolerate:

• Three shorter walks

Or replace some walking with:

• Cycling
• Pool exercise
• Strengthening exercises

The objective is to maintain activity without repeatedly provoking major pain.

Should I Exercise Through Hip Pain?

Not aggressively.

Some discomfort during rehabilitation can occur, but repeatedly causing substantial pain may make it difficult to progress.

Exercise can be adjusted by changing:

• Resistance
• Range of movement
• Duration
• Frequency
• Type of activity

The goal is progressive loading, not proving that you can tolerate pain.

2. Physiotherapy for Hip Arthritis

Physiotherapy may help improve:

• Hip movement
• Gluteal strength
• Leg strength
• Balance
• Walking
• Functional activities

AAOS recommends physical therapy as a non-surgical option for mild to moderate hip osteoarthritis based on evidence that it can improve pain and function.

What Should Hip Physiotherapy Include?

A programme may include:

• Hip mobility exercises
• Gluteal strengthening
• Leg strengthening
• Balance training
• Walking progression
• Functional training

The exact programme should match what you actually need to do in everyday life.

For example:

Someone struggling to get out of a chair may need a different programme from someone trying to return to golf.

What if Physiotherapy Has Not Worked?

If you have already spent several weeks or months doing physiotherapy without meaningful improvement, it may be time to reassess rather than simply purchase another identical treatment package.

Useful questions include:

• Is hip arthritis really the main source of pain?
• Could the pain be coming from the lower back?
• Is there another hip condition?
• Is the exercise programme appropriate?
• Is the arthritis more advanced than initially thought?
• Would imaging change treatment?
• Would an injection help?

Treatment that is not producing progress should be reviewed.

3. Activity Modification

Activity modification does not mean giving up everything you enjoy.

It means reducing unnecessary aggravation.

For example, someone with hip arthritis may temporarily reduce:

• Long-distance walking
• Repeated stair climbing
• Running
• High-impact exercise

while replacing these activities with:

• Cycling
• Swimming
• Shorter walks
• Strengthening

AAOS recommends reducing activities that aggravate hip pain and substituting lower-impact activities where appropriate.

Should I Stop Walking Completely?

Usually not.

Too little activity can contribute to:

• Weakness
• Reduced mobility
• Poor balance
• Loss of fitness

The aim is normally to find a sustainable amount of movement rather than completely resting the hip.

4. Weight Management

If you are above a healthy weight, weight management may reduce the mechanical load placed on the hip.

AAOS includes weight reduction among non-surgical strategies that may reduce stress on the hip and improve symptoms.

This does not mean every person with hip arthritis needs to lose weight.

It is relevant when excess body weight is contributing to joint loading and overall health risk.

What if Hip Pain Makes Exercise Difficult?

This creates a common cycle:

Hip hurts → exercise less → strength falls → weight increases → hip becomes harder to manage.

Breaking that cycle may require several strategies together:

• Lower-impact activity
• Physiotherapy
• Nutrition changes
• Medical weight-management support where appropriate
• Better pain control

Weight management does not have to depend entirely on vigorous exercise.

5. Medication

Medication may be useful for selected patients.

Options can include:

• Simple pain medication
• Anti-inflammatory medication

depending on the patient’s:

• Medical conditions
• Kidney function
• Stomach history
• Cardiovascular risks
• Other medications

AAOS notes that non-steroidal anti-inflammatory drugs can provide short-term improvement in hip osteoarthritis pain and function.

Medication should be selected individually rather than used indefinitely without review.

Does Medication Fix Hip Arthritis?

No.

Medication mainly helps control symptoms.

It does not reverse established cartilage and joint changes.

Better pain control can, however, make it easier to:

• Walk
• Exercise
• Sleep
• Participate in rehabilitation

6. Can a Walking Stick Help?

Yes, for selected patients.

A walking aid may reduce load on a painful hip and improve confidence with walking.

Mayo Clinic includes use of a cane among conservative strategies that may help some people with hip osteoarthritis.

A physiotherapist can help determine:

• Whether you need one
• Appropriate height
• Which hand should hold it

7. Can a Steroid Injection Help Hip Arthritis?

Yes, in selected patients.

A corticosteroid injection into the hip joint may provide:

• Temporary pain relief
• Improved movement
• Better ability to participate in rehabilitation

AAOS reports that intra-articular corticosteroid injections can improve pain and function in the short term for symptomatic hip osteoarthritis.

Does a Steroid Injection Cure Hip Arthritis?

No.

It does not regrow cartilage or reverse arthritis.

Its role is generally:

Temporary symptom relief.

This may nevertheless be useful when pain is preventing someone from:

• Walking
• Sleeping
• Exercising
• Participating in physiotherapy

How Long Does a Hip Steroid Injection Last?

It varies.

Some patients experience useful temporary relief.

Others experience little benefit.

AAOS characterises the benefit as primarily short-term rather than a permanent treatment.

What About Hyaluronic Acid Injections for Hip Arthritis?

This is an area where it is important to distinguish marketing from evidence.

AAOS guidance does not recommend hyaluronic acid injections for symptomatic hip osteoarthritis, reporting that they have not demonstrated benefit over placebo.

This differs from the way these injections are sometimes marketed commercially.

What About PRP or “Regenerative” Injections?

PRP and other biologic injections are marketed for osteoarthritis, but evidence and regulatory status vary by treatment and jurisdiction.

Mayo Clinic notes that several biologic injection approaches remain investigational in this context rather than established replacements for standard arthritis care.

Before paying for any treatment advertised as “regenerative”, useful questions include:

• What exactly is being injected?
• What evidence supports it?
• Is it approved for this use?
• What benefit should realistically be expected?
• How long is that benefit likely to last?
• What are the risks?

Can Hip Cartilage Be Regrown Without Surgery?

Established osteoarthritis involves structural changes within the joint.

Current conventional non-surgical treatments primarily aim to improve:

• Pain
• Movement
• Strength
• Function

rather than restore the hip to its original anatomical condition.

Be cautious about treatments that guarantee cartilage regrowth.

Does Shockwave Therapy Treat Hip Arthritis?

Shockwave therapy is better established for certain tendon-related conditions than for cartilage loss inside the hip joint.

For example, outer hip pain caused by tendon problems is different from osteoarthritis inside the joint.

This is one reason establishing the correct diagnosis matters before treatment.

How Can I Tell Whether My Pain Is Really From Hip Arthritis?

Hip arthritis often causes pain around the:

Groin

and may also produce:

• Thigh pain
• Buttock pain
• Knee pain
• Stiffness

Common functional problems include:

• Difficulty putting on shoes
• Difficulty getting out of a low chair
• Reduced walking distance
• Reduced hip rotation

However, similar pain can arise from:

• Gluteal tendon problems
• Lower-back conditions
• Nerve irritation
• Other hip disorders

Could My “Hip Arthritis” Pain Actually Be Coming From My Back?

Yes.

Back and hip problems can overlap considerably.

If pain is associated with:

• Lower-back pain
• Shooting leg pain
• Tingling
• Numbness
• Weakness

then the lumbar spine may also need assessment.

An X-ray showing some hip arthritis does not automatically prove that the hip is responsible for every symptom.

Do I Need an X-Ray for Hip Arthritis?

X-ray is usually the most useful initial imaging test when hip osteoarthritis is suspected.

It may show:

• Joint-space narrowing
• Bone spurs
• Bone changes
• Cysts
• Other degenerative findings

AAOS notes that X-rays can demonstrate these characteristic features of hip osteoarthritis.

Do I Need an MRI for Hip Arthritis?

Not always.

If:

• Symptoms are typical
• Examination fits hip arthritis
• X-rays already show osteoarthritis

then MRI may add little to the initial treatment plan.

MRI becomes more useful when:

• Symptoms do not match the X-ray
• Another diagnosis is suspected
• Pain remains unexplained
• A tendon, labral or other soft-tissue problem is being considered
• Additional structural information would change treatment

Is MRI Better Than X-Ray?

Not automatically.

They answer different questions.

X-Ray Is Particularly Useful For:

• Osteoarthritis
• Bone alignment
• Fracture
• Joint-space narrowing

MRI Is Particularly Useful For:

• Tendons
• Labrum
• Cartilage
• Muscles
• Bone marrow
• Other soft tissues

For straightforward hip osteoarthritis, the less expensive X-ray may often be the more useful first investigation.

Does MRI Use Radiation?

No.

MRI uses a magnetic field and radiofrequency energy rather than ionising radiation.

How Much Does a Hip MRI Cost in Singapore?

When MRI is medically appropriate, many standard hip MRI examinations arranged through The Pain Relief Clinic cost approximately:

S$1,000

This generally includes:

• MRI examination
• MRI images
• Formal radiologist’s report

Can MediSave Be Used for a Hip MRI?

Eligible outpatient diagnostic scans may qualify for:

Up to S$600 per patient per year from MediSave

Singapore’s Ministry of Health confirms that the annual MediSave outpatient-scan withdrawal limit increased from S$300 to S$600 from 1 January 2026.

Eligibility remains subject to prevailing rules and the patient’s remaining annual limit.

How Quickly Can a Hip MRI Be Arranged?

When MRI is medically appropriate, The Pain Relief Clinic can often arrange hip imaging:

Within one working day

subject to:

• MRI safety screening
• Correct imaging protocol
• Appointment availability

When Should Hip Replacement Be Considered?

Hip replacement becomes more relevant when:

• Hip pain substantially limits everyday activity
• Walking distance has become very restricted
• Night pain is persistent
• Quality of life is significantly affected
• Non-surgical treatment is no longer sufficient

Mayo Clinic states that hip replacement may be appropriate when pain interferes with daily activities and conservative treatment has failed or stopped providing adequate relief.

Should I Delay Hip Replacement for as Long as Possible?

Not necessarily.

There is an important difference between:

Avoiding unnecessary surgery

and

Avoiding necessary surgery at all costs.

If you remain reasonably functional with conservative care, continuing non-surgical treatment may make sense.

But if:

• You can barely walk
• Sleep is repeatedly disrupted
• Everyday life has become very restricted
• Appropriate non-surgical treatment has failed

then discussing hip replacement with an orthopaedic surgeon may be appropriate.

Does Seeing an Orthopaedic Surgeon Mean I Must Have Surgery?

No.

An orthopaedic consultation can help you understand:

• How advanced the arthritis is
• Whether surgery is actually appropriate
• Expected benefits
• Recovery
• Potential risks

You can then make an informed decision.

Is Hip Replacement Effective?

Hip replacement is designed to replace the damaged joint surfaces with artificial components and can substantially reduce pain and improve function in appropriately selected patients.

However, it is still major surgery and has potential complications.

It should therefore be considered when the expected benefit justifies those risks.

Which Doctor Should I See for Hip Arthritis?

A licensed medical doctor can initially assess:

• Whether symptoms fit hip osteoarthritis
• Whether the pain could be coming from the back
• Whether X-ray is appropriate
• Whether physiotherapy may help
• Whether medication or injection treatment may be considered
• Whether MRI is actually necessary
• Whether orthopaedic referral is appropriate

You do not necessarily need to start with a surgeon.

Frequently Asked Questions About Hip Arthritis Treatment Without Surgery

Can hip arthritis be treated without surgery?

Yes. Exercise, physiotherapy, activity modification, weight management where relevant, medication and selected injections can help many people manage hip osteoarthritis without immediate surgery.

Can physiotherapy help hip arthritis?

Yes. AAOS supports physical therapy for improving pain and function in people with mild to moderate symptomatic hip osteoarthritis.

Is cycling good for hip arthritis?

It can be. Lower-impact activities such as cycling and swimming may be easier on an arthritic hip than high-impact exercise.

Can weight loss help?

If you are above a healthy weight, reducing weight can decrease stress on the hip and may improve symptoms.

Do steroid injections work?

Corticosteroid injections can provide short-term improvement in pain and function for some patients.

Are hyaluronic acid injections recommended for hip arthritis?

Current AAOS guidance does not recommend them for symptomatic hip osteoarthritis because they have not demonstrated meaningful benefit over placebo.

Do I need an MRI?

Not necessarily. X-ray is often sufficient when hip osteoarthritis is clinically straightforward. MRI is more useful when another condition is suspected or symptoms remain unexplained.

How much does a hip MRI cost?

A hip MRI arranged through The Pain Relief Clinic is approximately S$1,000 for many standard examinations, including the MRI images and formal radiologist’s report.

Can I use MediSave for MRI?

Eligible outpatient diagnostic scans may qualify for up to S$600 per patient per year from MediSave, subject to prevailing requirements and available limits.

When should I consider hip replacement?

Hip replacement becomes more relevant when pain significantly interferes with daily activities and appropriate non-surgical treatment is no longer providing acceptable relief.

Want to Manage Hip Arthritis Without Surgery?

Being diagnosed with hip arthritis does not mean that your next appointment needs to be for hip replacement.

A useful first step is to determine:

• Whether the hip really is the main source of pain
• How much function has been lost
• Whether physiotherapy is appropriate
• Whether weight management may help
• Whether medication or an injection is reasonable
• Whether X-ray is sufficient
• Whether MRI would genuinely change treatment
• Whether orthopaedic referral is necessary now

At The Pain Relief Clinic, hip pain can be assessed by a licensed medical doctor with access to in-house physiotherapy and fast diagnostic imaging where medically appropriate.

Hip arthritis assessment through The Pain Relief Clinic

• Medical assessment by a licensed medical doctor
• In-house physiotherapy
• Strength and functional assessment
• Non-surgical treatment where appropriate
• Weight-management support where relevant
• Fast access to X-ray or MRI when indicated
• Hip MRI often available within one working day
• Approximately S$1,000 for many hip MRI examinations
• Up to S$600 MediSave for eligible outpatient diagnostic scans
• Formal radiologist’s report
• Assistance with relevant insurance documentation
• Orthopaedic referral when appropriate

Arrange a Hip Arthritis Assessment

The Pain Relief Clinic

Call / WhatsApp: +65 9068 9605

If hip arthritis is limiting your walking, stairs, exercise, sleep or daily activities, contact us for an assessment and a practical non-surgical treatment plan before deciding whether hip replacement is necessary.

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References

1. American Academy of Orthopaedic Surgeons — Osteoarthritis of the Hip: Plain Language Summary.
2. American Academy of Orthopaedic Surgeons — Osteoarthritis of the Hip Clinical Guidance.
3. Mayo Clinic Orthopedics & Sports Medicine — Early/Mild Arthritis Treatment.
4. Mayo Clinic — Osteoarthritis: Diagnosis and Treatment.
5. Mayo Clinic — Hip Replacement.
6. Singapore Ministry of Health — Adequacy of S$600 Annual MediSave Withdrawal Limit for Outpatient CT and MRI Scans, 6 August 2026.
7. Singapore Ministry of Health — Keeping Healthcare Affordable and Sustainable for All.

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Important Medical Information

This article provides general educational information and does not replace an individual medical consultation.

Hip pain can arise from osteoarthritis, tendons, muscles, the lower back, nerves or other conditions. An X-ray showing arthritis does not necessarily prove that every symptom is coming from the hip joint.

Treatment should be individualised according to symptoms, examination findings, overall health, imaging where appropriate and response to previous treatment.

Seek prompt medical assessment for severe pain following trauma, inability to bear weight, visible deformity, sudden major deterioration, or a hot painful joint associated with fever.

Reviewed by Dr Terence Tan, Founder of The Pain Relief Clinic — 19 September 2026